Pregnancy Affected By the Branch Retinal Artery Thrombosis: A Case Report

Pregnancy is associated with multiple changes in the maternal body to meet the growing needs of carrying the baby. Alterations in the coagulation system during pregnancy produce a hypercoagulable state to ensure haemostasis after delivery. Branch retinal artery occlusion (RAO) in pregnancy is rare but potentially vision threatening emergency. We report a 38-year-old multigravida who was having idiopathic intra uterine growth restriction for which her induction of labour was planned. She presented at 37 weeks in the ophthalmology clinic with sudden decrease in the left eye vision. Her optic coherence tomography (OCT) was done, and inferio-temporal peripheral retinal artery occlusion was diagnosed. She was admitted in the intensive care unit (ICU) for thorough evaluation and was started on heparin infusion as her induction was planned on the same day. However, her evaluation revealed no identifiable cause after complete cardiac, vascular and haematological work up. After 24 hours of initiation of heparin, 6 hours break was given and once PT and aPTT was normal, she was induced and delivered an IUGR female baby with good Apgar score normally. After 6 hours of the delivery prophylactic dose of enoxaparin sodium was given which was shifted to therapeutic dose after 24 hours. After the heparin the clinical improvement was noted which was confirmed by OCT after 8 days of the delivery. However oral anticoagulants were continued for 3 months.